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Thursday, July 14, 2016

Opportunities for patients undergoing
hemodialysis to receive chemotherapy are increasing. A combination of
paclitaxel and carboplatin (TC) is first‑line chemotherapy in patients
with Müllerian cancer. However, the optimal dose and time interval
between the end of carboplatin administration and initiation of
hemodialysis remains to be elucidated. TC was administered to a patient
with fallopian tube cancer undergoing hemodialysis. The paclitaxel
regimen was determined to be 135 mg/m2 (total of 210 mg) over 3 h. After
paclitaxel administration, 125 mg of carboplatin was administered over
1 h to achieve a target area under the concentration‑time curve (AUC) of
5.0 mg•min/ml using the Calvert formula. The time interval between the
end of carboplatin administration and hemodialysis initiation was 1 h at
the first cycle, 16 h at the second cycle and 20 h at the third cycle,
and the AUC obtained was 2.86, 4.16 and 6.0 mg•min/ml, respectively. The
desired AUC of free platinum was demonstrated and only mild side
effects were observed at the third cycle. Therefore, hemodialysis was
initiated 20 h after completion of carboplatin infusion at cycles 4‑6.
The total chemotherapy planned was completed without severe adverse
events. Measurement of the concentration of free platinum subsequent to
administration is useful for determination of the optimal dose of
carboplatin and time interval following administration to obtain an
adequate AUC. The present study suggests that carboplatin can be
administered to a patient undergoing hemodialysis, and that an adequate
interval between the end of carboplatin administration and hemodialysis
initiation may be ~20 h.